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Rheumatic heart disease: prevalence and preventive measures in the Indian subcontinent

2001; BMJ; Volume: 86; Issue: 2 Linguagem: Inglês

10.1136/heart.86.2.127

2053-5864

S Padmavati,

Streptococcal Infections and Treatments

Rheumatic heart disease: prevalence and preventive measures in the Indian subcontinent Although once considered a rarity in the Indian subcontinent, the prevalence of rheumatic heart disease (RHD) is now recognised to be very high, particularly among children and young adults. 1 Indeed, such was the severity of the problem in developing countries that in 1982 the World Health Organization/International Society and Federation of Cardiology established a committee to combat the disease over a phased period.As a result, the prevalence of RHD has subsided in certain countries in the Middle East, and in Thailand. 2n contrast to previous sources of data upon which to base the prevalence of RHD (for example, necropsies, general population surveys, insurance data 3 ), prevalence figures over the past five years have been derived almost entirely from school surveys.Between 1940 and 1983, the prevalence rate for RHD varied from 1.8 to 11 per 1000 (national average 6 per 1000), while between 1984 and 1995 the rate varied from 1 to 5.4 per 1000.During the same periods of time, the prevalence of rheumatic fever ranged from 0.06 to 5.01 and 0.32 to 0.54 per 1000, respectively.Because of the diVerent methods of collecting the data it is not possible to be certain that these figures represent a fall in the prevalence of RHD.By comparison, in western countries the prevalence of RHD in children aged between 5-15 years is below 0.5 per 1000, 4 and for rheumatic fever it is below 1 per 1000.